The effects of sodium hypochlorite and calcium hydroxide on tissue dissolution and root canal cleanliness

In this in vitro study, we investigated the efficacy of sodium hypochlorite (NaOCl) and calcium hydroxide (Ca(OH)₂) in dissolving necrotic tissue and cleaning root canals. In the first part of the study, 0.5% NaOCl solution and Ca(OH)₂ paste and solution were tested with samples of necrotic bovine muscle in different treatment modes and for different periods. The necrotic tissue was weighed before and after the test and the percentage of weight change calculated. In the second part of the study, 40 extracted single-rooted human teeth were hand instrumented and then subjected to different irrigation regimens. The cleansing efficacy in root canals of 0.5% NaOCl with Ca(OH)₂ pretreatments and ultrasonics was examined using scanning electron microscopy. A solution of 5% NaOCl was significantly more effective than 0.5 % NaOCl as a solvent of necrotic tissue. Calcium hydroxide was an effective solvent for necrotic tissue as a paste but not as a solution. Pretreatment of necrotic tissue with Ca(OH)₂ increased its solubility in 0.5% NaOCl. While 5 % NaOCl plus ultrasonic irrigation produced cleaner root-canal walls at the middle and apical thirds, 0.5% NaOCl used with the same technique achieved no root-canal cleaning. However, pretreatment of root canals with Ca(OH)₂ paste increased the effectiveness of 0.5% NaOCl plus ultrasonic irrigation, except in the coronal third of the root canal.     

Peripheral and central conduction in n-hexane polyneuropathya

Electrophysiological findings of 27 males with industrial n-hexane polyneuropathy (HPNP) are presented. The results of needle electromyography and nerve conduction studies were compatible with primarily axonal polyneuropathy with secondary segmental demyelination. Motor conduction velocities were the slowest in distal regions of the nerves. In the proximal nerve segments, which were partly tested by magnetic stimulation of the nerve roots, this slowing was much less pronounced. The reduction in mean motor conduction velocities in the forearm segments of ulnar nerves was more than 30% in comparison to the control group means. This reduction was only 10% in the neckaxilla segments. We think that this finding is a reflection of the distal axonopathy process. Central motor conduction times calculated by transcranial magnetic stimulation and spinal nerve root stimulation were found to be prolonged in HPNP patients, indicating that descending motor pathways are affected in human HPNP. © 1994 John Wiley & Sons, Inc.     

Sotalol: A new β-adrenergic blocker for ventricular arrhythmias

Sotalol is a water-soluble, nonselective, β-adrenergic blocker that was recently approved in oral form in the United States for the treatment of ventricular arrhythmias that are judged to be life-threatening. As a β-blocker, sotalol is unique in having additional class-III antiarrhythmic activity. It is still not resolved whether sotalol is more effective than other β-blockers in managing arrhythmias, but there are suggestions that it might possess greater antiarrhythmic and life-protecting activities than other types of antiarrhythmic drugs. The drug is well tolerated, but, because of its electrophysiologic activity, there is a small risk of proarrhythmia, specifically the development of polymorphic ventricular tachycardia and torsade de pointes.     

Supraventricular tachyarrythmia prophylaxis after coronary artery surgery in chronic obstructive pulmonary disease patients (early amiodarone prophylaxis trial).

OBJECTIVES: Supraventricular tachyarrhythmias (SVT) is common after coronary artery bypass grafting in chronic obstructive pulmonary disease (COPD). Preoperative FEV(1) is the major predetermining factor of mortality, morbidity and SVT. METHODS: Patients were divided into two groups according to their preoperative FEV(1) values. FEV(1) is <75% of predicted value in group 1 (no. 200), and >/=75% of predicted value in group 2 (no. 100). Group 1 is divided into two subgroups. SVT prophylaxis was not done in A subgroup (no. 100) whereas arrhythmia prophylaxis was done with amiodarone in all B subgroups (no. 100) in the early postoperative period. RESULTS: Atrial fibrillation developed in 28 patients in group 1A, whereas it developed in 12 in group 1B (P=0.005). Atrial flutter developed in 10 patients in group 1A but in 3 patients in group 1B (P=0.045). Multifocal atrial tachycardia developed in 13 patients in group 1A and in 4 in group 1B (P=0.022). Multivariate analysis identified ejection fraction (P<0.002, odds ratio (OR) 0.93), inotropy requirement (P<0.001, OR 3.98) amiodarone (P<0.001, OR 0.18), and FEV(1)<75% of predicted value (P<0.048, OR 1.84) as predictor of SVT. There were statistically significant differences between A and B subgroups of group 1 for hospital (P<0.001) and intensive care unit (ICU) stay (P<0.001). There was also statistically significant difference between groups 1A and 2 comparison for ICU (P<0.001; 6.4+/-3.4 versus 1.4+/-0.6 days) and hospital stay (P<0.001; 17.6+/-8.2 versus 6.9+/-0.6 days). CONCLUSIONS: Early prophylactic amiodarone not only significantly reduces SVT but also reduces SVT-related hospital and ICU stay. We strongly recommend prophylactic early use of amiodarone in COPD patients.     

Successful treatment of severe aplastic anemia associated with human parvovirus B19 and Epstein-Barr virus in a healthy subject with allo-BMT.

Several reports have noted pancytopenia associated with Human parvovirus B19 (PVB19) or Ebstein-Barr virus (EBV) infections in patients who have no history of immunodeficiency. To our knowledge, we report the first case of severe aplastic anemia associated with both EBV and PVB19 infections in a previously healthy 22-year-old man. He was admitted to our hematology service due to anemia and thrombocytopenia. He had no symptoms or signs of infections of these viruses. His bone marrow biopsy revealed a hypocellular marrow. Specific IgM and IgG antibodies to EBV and PVB19 were elevated. EBV and PVB19 virus genomes were detected by PCR in the bone marrow nucleated cells and the peripheral blood lymphocytes. Two months after treatment with prednisone, acyclovir, and intravenous immune globulin (IVIg), the genomes of both these viruses disappeared. However, his transfusion requirement for platelet suspensions and packed red blood cells persisted. The patient underwent allogeneic bone marrow transplant (allo-BMT) and has had an enduring complete hematological response for 8 months.     

The role of polytetrafluoroethylene graft material in Buerger's disease

The early and long-term results of polytetrafluoroethylene (PTFE) grafts in different anatomical locations were evaluated in 14 patients with Buerger's disease (thromboangiitis obliterans). During a 10-year period, 2160 patients with peripheral vascular disease were treated and, in 258, the diagnosis of Buerger's disease was made. Fourteen of these 258 patients underwent revascularization with PTFE grafts. In a follow-up period, up to 8 years patency rates were as follows: aorto/ilofemoral bypass 80%, femoropopliteal bypass 40%, femorocrural bypass 50% with a cumulative patency rate of 57.1%, and limb salvage rate of 88.9%. Because of the diverse nature and small number of the operations, the numerical results are not amenable to statistical analysis, but 88.9% limb salvage rate is satisfying in Buerger's disease. To the best of our knowledge, this is the first report on the use of PTFE grafts in Buerger's disease and it validates limb salvage even below the inguinal ligament.Presented at the 37th Annual World Congress, International College of Angiology, Helsinki, Finland, July 1995     

Comparison of sensitivities of macro EMG and concentric needle EMG in L4 radiculopathy

Abstract. The purpose of this study was to compare the sensitivities of macro EMG (mEMG) and concentric needle EMG (cnEMG) in showing abnormality in L4 radiculopathy. We evaluated 23 patients with clinically and radiologically proven L4 root lesions. Among these patients, 21 (92%) had cnEMG abnormalities. Out of 21 patients with cnEMG abnormality, 3 (14%) had fibrillations and positive sharp waves, 8 (38%) had interference pattern abnormality and all of them had motor unit potential (MUP) abnormality on quantitative MUP analysis. Seventeen patients (74%) had mEMG abnormality. Diagnostic yield of cnEMG is higher than mEMG in L4 radiculopathy. mEMG may not contribute much to the diagnosis of lumbar radiculopathy.Presented in part at the 18th Annual Meeting of the Turkish Clinical Neurophysiology EEG-EMG Society, June 2002, Turkey.     

Serum leptin concentration and advanced gastrointestinal cancers: a case controlled study

Background  

Serum leptin level is associated with appetite and energy expenditure in healthy individuals. We aimed to evaluate the serum leptin concentration and the other factors which may be associated with weight loss in patients with advanced gastrointestinal cancer.     

The prevalence of seminal vesicle cysts in autosomal dominant polycystic kidney disease

Background: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by bilateral diffuse renal cysts. Extrarenal involvement is a well known manifestation of ADPKD. Data relating to the association between seminal vesicle cysts and ADPKD are limited. The aims of this study are to evaluate the frequency of seminal vesicle cysts in ADPKD and to assess the relationship between seminal vesicle cysts, with cysts in the liver and prostate, and creatininaemia. Methods: Forty five male patients (mean age 40 years, range 13-67) were included in the study. Each subject underwent a formal interview, physical examination; and abdominal and transrectal ultrasonography. Three patients were infertile, but one of the patients also had varicocele. Results: Seminal vesicle cysts were present in 27 (60%) patients. Liver and prostate cysts were present in 19 (42%) and five (11%) patients, respectively. There was a positive correlation between seminal vesicle cysts, cysts in the liver, and serum creatinine concentrations. Conclusion: Our conclusions are: (i) seminal vesicle cysts are not uncommon in ADPKD; (II) ADPKD should be looked for in patients with seminal vesicle cysts, and (iii) the clinical significance of seminal vesicle cysts in ADPKD remains to be defined.